CoAEMSP INTERPRETATIONS OF THE CAAHEP 2015 … · This companion document contains the CAAHEP...

This companion document contains the CAAHEP Standards and Guidelines for the Accreditation of

Educational Programs in the Emergency Medical Services Professions with CoAEMSP

interpretations adopted by CoAEMSP through policies. The interpretations are NOT part of the

Standards and Guidelines document and are subject to change by CoAEMSP. Policy revisions may

occur often, so this document should be reviewed frequently to ensure the most current version.

Please refer to the Glossary for the definition of terms which is available at www.coaemsp.org/standards.

Questions regarding the interpretations can be directed to the CoAEMSP Executive Office. [Standards

interpretations first approved by CoAEMSP August 2010; revisions February 2011, August 2011, August

2012, February 2013, February 2014, August 2014, August 2015, February 2016, August 2016, February

2017]

Description of the Profession (as per EMS Agenda for Future, NHTSA)

The Emergency Medical Services Professions include four levels: Paramedic, Advanced EMT, EMT, and

Emergency Medical Responder. CAAHEP accredits educational programs at the Paramedic and Advanced

EMT levels. Programs at the EMT and Emergency Medical Responder levels may be included as exit points

in CAAHEP-accredited Paramedic and Advanced EMT programs. “Stand-alone” EMT and Emergency

Medical Responder programs may be reviewed by the Committee on Accreditation of Educational Programs

for the Emergency Medical Services Professions (CoAEMSP).

Paramedic

The Paramedic is an allied health professional whose primary focus is to provide advanced emergency

medical care for critical and emergent patients who access the emergency medical system. This individual

possesses the complex knowledge and skills necessary to provide patient care and transportation.

Paramedics function as part of a comprehensive EMS response, under medical oversight. Paramedics

perform interventions with the basic and advanced equipment typically found on an ambulance. The

Paramedic is a link from the scene into the health care system.

Advanced Emergency Medical Technician

The primary focus of the Advanced Emergency Medical Technician is to provide basic and limited advanced

emergency medical care and transportation for critical and emergent patients who access the emergency

medical system. This individual possesses the basic knowledge and skills necessary to provide patient care

and transportation. Advanced Emergency Medical Technicians function as part of a comprehensive EMS

response, under medical oversight. Advanced Emergency Medical Technicians perform interventions with

the basic and advanced equipment typically found on an ambulance. The Advanced Emergency Medical

Technician is a link from the scene to the emergency health care system.

Emergency Medical Technician

The primary focus of the Emergency Medical Technician is to provide basic emergency medical care and

transportation for critical and emergent patients who access the emergency medical system. This individual

possesses the basic knowledge and skills necessary to provide patient care and transportation. Emergency

Medical Technicians function as part of a comprehensive EMS response, under medical oversight.

Emergency Medical Technicians perform interventions with the basic equipment typically found on an

ambulance. The Emergency Medical Technician is a link from the scene to the emergency health care

system.

CoAEMSP INTERPRETATIONS OF THE

CAAHEP 2015 STANDARDS AND GUIDELINES

For the Accreditation of Educational Programs in the EMS Professions

http://www.coaemsp.org/standards

Emergency Medical Services (Standards Interpretations 02.03.2017) Page 2 of 32

Emergency Medical Responder

The primary focus of the Emergency Medical Responder is to initiate immediate lifesaving care to critical

patients who access the emergency medical system. This individual possesses the basic knowledge and

skills necessary to provide lifesaving interventions while awaiting additional EMS response and to assist

higher level personnel at the scene and during transport. Emergency Medical Responders function as part

of a comprehensive EMS response, under medical oversight. Emergency Medical Responders perform

basic interventions with minimal equipment.


TABLE OF CONTENTS

Description of the Profession (as per EMS Agenda for Future, NHTSA) .......................................................................... 1

Paramedic ....................................................................................................................................................................... 1

Advanced Emergency Medical Technician ..................................................................................................................... 1

Emergency Medical Technician ...................................................................................................................................... 1

Emergency Medical Responder ...................................................................................................................................... 2

STANDARD I SPONSORSHIP

Standard I.A. Sponsoring Institution .................................................................................................................................. 5

Standard I.B. Consortium Sponsor ..................................................................................................................................... 6

Standard I.C. Responsibilities of Sponsor ........................................................................................................................... 7

STANDARD II PROGRAM GOALS

Standard II.A. Program Goals and Outcomes ..................................................................................................................... 7

Standard II.B. Appropriate of Goals and Learning Domains .............................................................................................. 8

Standard II.C. Minimum Expectations ................................................................................................................................ 9

STANDARD III RESOURCES

Standard III.A.1. Program Resources .................................................................................................................................. 9

Standard III.A.2. Hospital/Clinical Affiliations and Field/Internship Affiliations .............................................................. 10

Standard III.B. Personnel ................................................................................................................................................. 12

Standard III.B.1.a. Program Director Responsibilities ...................................................................................................... 12

Standard III.B.1.b. Program Director Qualifications ......................................................................................................... 13

Standard III.B.2.a. Medical Director Responsibilities ....................................................................................................... 14

Standard III.B.2.b. Medical Director Qualifications .......................................................................................................... 15

Standard III.B.3.a. Associate Medical Director Responsibilities ....................................................................................... 16

Standard III.B.3.b. Associate Medical Director Qualifications .......................................................................................... 16

Standard III.B.4.a. Assistant Medical Director Responsibilities ........................................................................................ 17

Standard III.B.4.b. Assistant Medical Director Qualifications .......................................................................................... 17

Standard III.B.5.a. Faculty / Instructional Staff Responsibilities ...................................................................................... 18

Standard III.B.5.b. Faculty / Instructional Staff Qualifications ......................................................................................... 18

Standard III.B.6.a. Lead Instructor Responsibilities .......................................................................................................... 19

Standard III.B.6.b. Lead Instructor Qualifications ............................................................................................................ 19

Standard III.C.1. Curriculum ............................................................................................................................................ 20

Standard III.C.2. Curriculum (Tracking) ........................................................................................................................... 21


Standard III.C.3. Curriculum (Team Leads) ...................................................................................................................... 21

Standard III.D. Resource Assessment .............................................................................................................................. 22

STANDARD IV STUDENT AND GRADUATE EVALUATION/ASSESSMENT

Standard IV.A.1. Student Evaluation-Frequency and Purpose ........................................................................................ 23

Standard IV.A.2. Student Evaluation-Documentation ..................................................................................................... 24

Standard IV.B.1. Outcomes Assessment ......................................................................................................................... 26

Standard IV.B.2. Outcomes Reporting............................................................................................................................. 27

STANDARD V FAIR PRACTICES

Standard V.A.1. Publications and Disclosures ................................................................................................................. 28



Standard V.B. Lawful and Non-Discriminatory Practices ................................................................................................ 30

Standard V.C. Safeguards ................................................................................................................................................ 30

Standard V.D. Student Records ....................................................................................................................................... 30

Standard V.E. Substantive Change .................................................................................................................................. 31

Standard V.F. Agreements ............................................................................................................................................... 31


Standard I.A. Sponsoring Institution A sponsoring institution must be at least one of the following, and must either award credit for the program or have an articulation agreement with an accredited post-secondary institution:

1. A post-secondary academic institution accredited by an institutional accrediting agency that is recognized by the U.S. Department of Education, and authorized under applicable law or other acceptable authority to provide a post-secondary program, which awards a minimum of a diploma/certificate at the completion of the program.

2. A foreign post-secondary academic institution acceptable to CAAHEP, which is authorized under applicable law or other acceptable authority to provide a postsecondary program, which awards a minimum of a certificate/diploma at the completion of the academic program.

3. A hospital, clinic or medical center accredited by a healthcare accrediting agency or equivalent that

is recognized by the U.S. Department of Health and Human Services, and authorized under applicable law or other acceptable authority to provide healthcare, and authorized under applicable law or other acceptable authority to provide the post-secondary program, which awards a minimum of a diploma/certificate at the completion of the program.

4. A governmental (i.e., state, county, or municipal) educational or governmental medical service, and

which is authorized by the State to provide initial educational programs, and authorized under applicable law or other acceptable authority to provide the post-secondary program, which awards a minimum of a diploma/certificate at the completion of the program.

5. A branch of the United States Armed Forces or other Federal agency, which awards a minimum of

a certificate/diploma at the completion of the program. For a distance education program, the location of program is the mailing address of the sponsor.

Possible Evidence of Compliance For This Standard:

Valid institutional accreditation letter [All I.A.1 or I.A.3 sponsors] Legal authorization to provide postsecondary education [All I.A.2 sponsors] Articulation agreement [All I.A.2, I.A.3, I.A.4, and I.A.5 sponsors or I.A.1 sponsors that do

not award college credit for the program] Documentation indicating that each State EMS Office has been notified that the program

has students in that state [For out of state clinical/field sites if applicable]

Interpretation of Standard:

A sponsoring institution must be at least one of the following, and must either award credit for the program or have an articulation agreement with an accredited post-secondary institution: 1. This is a college, university, community college, junior college that is accredited by a regional or national

institutional accrediting body. Vocational schools, proprietary schools, and religious schools may be

STANDARD I. SPONSORSHIP


accredited by regional accrediting agencies or specialized institutional accrediting bodies. A list of approved accrediting organizations can be found on the US Department of Education web site.

If academic credits are not granted during the program offered in the accredited academic institution (e.g., the program is offered through continuing education), there must be an articulation agreement for those who complete the program.

For each state in which the program has enrolled students, the program must document that it has successfully notified the State EMS office that the program has students in that state.

2. This will be determined on a case-by-case basis. 3. A hospital, clinic, or medical center may be a sponsor under certain conditions. The hospital, clinic, or

medical center must maintain permanent records, must insure quality of the program, and must assure that all fair practices are followed.

A hospital, clinic, or medical center, may be a sponsor under # 3: • It must be accredited by The Joint Commission or its equivalent, and authorized by the State to

provide health care • It must have an articulation agreement with an accredited educational institution (Standard I.A.1)

that can provide college credits for the training An articulation agreement is an agreement between an educational institution and a training facility to provide college credit to individuals completing the training program. This agreement allows students to receive college credit if they enroll at the educational institution; it does not require that students who do not register receive college credit. The articulation agreement may be composed as a memorandum of understanding, transfer agreement, or other suitable instrument, as long as the requirements of articulation are met.

4. A governmental fire academy or EMS training agency may be a sponsor under #4 – It must be an agency of the federal, state, city, or county government – It must be authorized by the State to provide initial educational programs – It must

- - EITHER - -

have an articulation agreement with an educational institution (Standard I.A1) that can provide

college credits for the training, if it cannot give credits in its own rights

- - OR - - be recognized by the state as a post-secondary educational institution

Standard I.B. Consortium Sponsor 1. A consortium sponsor is an entity consisting of two or more members that exists for the purpose of

operating an educational program. In such instances, at least one of the members of the consortium must meet the requirements of a sponsoring institution as described in I.A.

2. The responsibilities of each member of the consortium must be clearly documented in a formal affiliation agreement or memorandum of understanding, which includes governance and lines of authority.



Current fully executed consortium agreement, contract, or memorandum of understanding. [Consortium Sponsorship Agreement sample available at http://coaemsp.org/Standards.htm].

Organizational chart Consortium governing body meeting minutes (most current or specific # of years’ worth?) Articulation agreement


A consortium agreement is an agreement, contract, or memorandum of understanding between two entities to provide governance of a program. The members of the consortium set up a separate Board to establish and run an educational program. The governance, lines of authority, roles of each partner must be established in the agreement, and have an organizational chart.

Standard I.C. Responsibilities of Sponsor The Sponsor must ensure that the provisions of these Standards and Guidelines are met.


No current interpretation for this Standard.

Standard II.A. Program Goals and Outcomes There must be a written statement of the program’s goals and learning domains consistent with and responsive to the demonstrated needs and expectations of the various communities of interest served by the educational program. The communities of interest that are served by the program must include, but are not limited to: students, graduates, faculty, sponsor administration, hospital/clinic representatives, employers, police and/or fire services with a role in EMS services, key governmental officials, physicians, and the public. The Advisory Committee should have significant representation and input from non-program personnel. Advisory committee meetings may include participation by synchronous electronic means. Program-specific statements of goals and learning domains provide the basis for program planning, implementation, and evaluation. Such goals and learning domains must be compatible with the mission of the sponsoring institution(s), the expectations of the communities of interest, and nationally accepted standards of roles and functions. Goals and learning domains are based upon the substantiated needs of health care providers and employers, and the educational needs of the students served by the educational program.

STANDARD II. PROGRAM GOALS

http://coaemsp.org/Standards.htm



List of current advisory committee members identifying at least one representative from each required group

Advisory committee meeting minutes and attendance from past three (3) years.


The minimum goal is listed under II.C below. This is a required goal. The program can have any additional goals that it wishes, but those goals must be measurable and the program must evaluate the goal(s) and have the Advisory Committee assist in formulating and revising the goal(s) at least annually.

Standard II.B. Appropriate of Goals and Learning Domains The program must regularly assess its goals and learning domains. Program personnel must identify and respond to changes in the needs and/or expectations of its communities of interest. An advisory committee, which is representative of at least each of the communities of interest named in these Standards, must be designated and charged with the responsibility of meeting at least annually, to assist program and sponsor personnel in formulating and periodically revising appropriate goals and learning domains, monitoring needs and expectations, and ensuring program responsiveness to change, and to review and endorse the program required minimum numbers of patient contacts.


Roster of current advisory committee members identifying at least one representative from each required group

Advisory committee meeting minutes and attendance from the past three (3) years. [Advisory Committee Agenda and Checklist form available at http://coaemsp.org/Evaluations.htm]


The Advisory Committee must meet at least once a year and review the goals, outcomes for the classes in the last year and make recommendations to the program. The Advisory Committee meetings should also include review of all minimum competency requirements, including team leads, achievement of goals, analysis of the goals, action plan, and results of action where appropriate and review of the annual report and other objective data that supports program evaluation. There must be an Advisory Committee roster indicating the communities of interest that the members represent. Police and fire services would be represented, if they have a role in EMS in the community served by the program. A key governmental official, where appropriate, could include an elected official, an appointed public official, an individual involved in emergency management, or other public official.

http://coaemsp.org/Evaluations.htm


The public member of the Advisory Committee should be a person who has valuable input to the program. The public member should not be employed by the sponsor or a clinical affiliate and should not qualify as any other named community of interest representative. The Advisory Committee meetings must have Minutes reflecting the attendees, and meaningful discussion and actions during the meeting.

Standard II.C. Minimum Expectations The program must have the following goal defining minimum expectations

· Paramedic: “To prepare competent entry-level Paramedics in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains with or without exit points at the Advanced Emergency Medical Technician and/or Emergency Medical Technician, and/or Emergency Medical Responder levels.”

· Advanced Emergency Medical Technician: “To prepare competent entry-level Advanced Emergency Medical Technician in the cognitive (knowledge), psychomotor (skills), and affective (behavior) learning domains,”

Programs adopting educational goals beyond entry-level competence must clearly delineate this intent and provide evidence that all students have achieved the basic competencies prior to entry into the field with or without exit points at the Emergency Medical Technician, and/or Emergency Medical Responder levels. Nothing in this Standard restricts programs from formulating goals beyond entry-level competence.


Published program goal(s) in program promotional materials, student handbook, advisory committee minutes, and/or other areas.



Standard III.A.1. Program Resources Program resources must be sufficient to ensure the achievement of the program’s goals and outcomes. Resources must include, but are not limited to: faculty; clerical and support staff; curriculum; finances; offices; classroom, laboratory, and, ancillary student facilities; clinical affiliates; equipment; supplies; computer resources; instructional reference materials, and faculty/staff continuing education.

STANDARD III. RESOURCES



Results of annual program resource assessment [using the CoAEMSP Resource Assessment Matrix (RAM)]


There are no set numbers for resources; only the requirement that the resources are sufficient as documented by the on-going Resource Assessment system (see Standard III.D) and other objective data. The same space can be used for class and lab provided the space is adequate for the number of students and accommodate the required activity. While a full-time clerical position might be ideal, the comparable amount of support can be provided by a combination of resources, such as part-time positions, clerical sharing, work study students. However, the sufficiency of the clerical support is objectively determined by the data collected for resource assessment. The objective measurement is reflected by the adequacy of program activities such as: timely filing of documents, phone coverage, organized records, up to date files, adequate correspondence turnaround time, regardless of the means by which the program accomplishes those tasks.

Standard III.A.2. Hospital/Clinical Affiliations and Field/Internship Affiliations For all affiliations, students must have access to adequate numbers of patients, proportionally distributed by age-range, chief complaint and interventions in the delivery of emergency care appropriate to the level of the Emergency Medical Services Profession(s) for which training is being offered. The clinical/field experience/internship resources must ensure exposure to, and assessment and management of the following patients and conditions: adult trauma and medical emergencies; airway management to include endotracheal intubation; obstetrics to include obstetric patients with delivery and neonatal assessment and care; pediatric trauma and medical emergencies including assessment and management; and geriatric trauma and medical emergencies.


Completed Appendix G – Student Patient Contact Matrix [Appendix G – Student Patient Contact Matrix for available at http://coaemsp.org/Self_Study_Reports.htm].

Advisory committee minutes [Advisory Committee Agenda and Checklist form available at http://coaemsp.org/Evaluations.htm].


The clinical resources must ensure exposure to, and assessment and management of the following patients and conditions: adult trauma and medical emergencies; airway management to include endotracheal intubation; obstetrics to include obstetric patients with delivery and neonatal assessment and care; pediatric trauma and medical emergencies including assessment and management; and geriatric trauma and medical emergencies. The program must set and require minimum numbers of patient contacts for each listed category.

http://coaemsp.org/Self_Study_Reports.htm

http://coaemsp.org/Evaluations.htm


Those minimum numbers must be approved by the Medical Director and endorsed by the Advisory Committee with documentation of those actions. The tracking documentation must then show those minimums and that each student has met them. There must be periodic evaluation that the established minimums are adequate to achieve competency. No minimum number can be fewer than two (2), including each pediatric age subgroup. The objectives must clearly state the intent of the rotation and outcomes required. While the specific units/rooms may provide the types of patients to meet the objectives, there are likely other locations and creative activities that can provide the necessary type of patient encounters. The access and availability of the patients is the critical issue. The location of the experiences is at the discretion of the program. For example, psychiatric patient exposures may occur in the emergency department. Live patient encounters must occur; however, appropriate simulations can be integrated into the educational process to provide skills acquisition, develop skills proficiency, provide practice opportunities for low volume procedures, and ensure competency prior to exposure to a patient. The program must show that this method of instruction is contributing to the attainment of the program’s goals and outcomes. In order for an interfacility transfer to be documented as a patient contact in the field experience or the capstone field internship, the patient must be transferred to a higher level of care requiring assessment and may require emergency care. For airway management: Each student must demonstrate competency in airway management. The program sets the required minimums approved by the Medical Director and Advisory Committee as described above. For example, the paramedic student should be successful in any combination of live patients, high definition simulations, low fidelity simulations, and/or cadaver labs in all age brackets (neonate, infant, pediatric, and adults). High definition simulation is highly recommended but optional. Low fidelity simulation is defined by traditional simulation heads. Paramedic students should have exposure to diverse environments of learning, including but not limited to hospital units (e.g., operating rooms, emergency departments, intensive care units), ambulatory surgical centers, and out of hospital settings (e.g., ambulance or field environments) and laboratories (floor, varied noise levels, varied lighting conditions). The paramedic student should have no fewer than fifty (50) attempts at airway management across all age levels, with a 90% success rate utilizing endotracheal intubation models in their last ten (10) attempts. The paramedic student needs to be 100% successful in the management of their last twenty (20) attempts at airway management. The majority of airway attempts should be emphasized with live intubations, realistic simulation labs, or both. As with all other required skills, terminal competency needs to be validated by the program medical director’s signature. Evaluation of the clinical and capstone field internship sites should be done by the program. They should ensure, through tracking (Standard III.C.2) that the clinical and capstone field internship sites provide the minimum requirements for competency (See II.C and IV.A.1).


Standard III.B. Personnel The sponsor must appoint sufficient faculty and staff with the necessary qualifications to perform the functions identified in documented job descriptions and to achieve the program’s stated goals and outcomes.

Standard III.B.1.a. Program Director Responsibilities The program director must be responsible for all aspects of the program, including, but not limited to:

1) the administration, organization, and supervision of the educational program,

2) the continuous quality review and improvement of the educational program,

3) long range planning and ongoing development of the program,

4) the effectiveness of the program, including instruction and faculty, with systems in place to

demonstrate the effectiveness of the program,

5) cooperative involvement with the medical director,

6) the orientation/training and supervision of clinical and field internship preceptors

7) the effectiveness and quality of fulfillment of responsibilities delegated to another qualified individual.


Written job description Documentation of employment Teaching and administrative workload assignments Faculty teaching schedules Evaluation and results of clinical/capstone field internship preceptor training Results of student course evaluations


As part of the administration, organization, and supervision of the program, the Program Director must ensure that there is preceptor orientation/training. The training/orientation must include the following topics:

Purposes of the student rotation (minimum competencies, skills, and behaviors)

Evaluation tools used by the program

Criteria of evaluation for grading students

Contact information for the program

Program’s definition of Team Lead

Program’s required minimum number of Team Leads

Coaching and mentorship techniques The training media may take many forms: written documents, formal course, power point presentation, video, on-line, or there could be designated trainers on-site that the program relies on. The program should tailor the method of delivery to the type of rotation (e.g. hospital, physician office, field). The program must demonstrate that each capstone field internship preceptor has completed the training. For example, there may be an on-line session documenting completion by the preceptor, or


there may be a written packet provided by the program, which is read and signed by the preceptor at the start of the rotation, or a representative of the program may meet briefly with the potential preceptors at that location. For capstone field internship experiences, the program should focus on the evaluation of the experience, but that evaluation must include an evaluation of each active capstone field internship preceptor. The program must identify a key person in hospitals (departments), in other clinical experience settings, and for field experience. The program must demonstrate that every key person has completed the orientation. The program can then arrange to have those key personnel provide guidance to any other preceptors in those settings. For clinical and field experiences, the program should focus on the evaluation of the experience, but that evaluation must include at least an overall, not necessarily individual, evaluation of the preceptors. The program must provide evidence of the completion of the training of capstone field internship preceptors by dated rosters of participants, on-line logs, signed acknowledgement by the capstone field internship preceptor.

Standard III.B.1.b. Program Director Qualifications The program director must:

1) possess a minimum of a Bachelor’s degree to direct a Paramedic program and a minimum of an

Associate’s degree to direct an Advanced Emergency Medical Technician program, from an accredited institution of higher education.

Program Directors should have a minimum of a Master's degree.

2) have appropriate medical or allied health education, training, and experience,

3) be knowledgeable about methods of instruction, testing and evaluation of students,

4) have field experience in the delivery of out-of-hospital emergency care,

5) have academic training and preparation related to emergency medical services at least equivalent to

that of a paramedic,

6) be knowledgeable about the current versions of the National EMS Scope of Practice and National

EMS Education Standards, and about evidenced-informed clinical practice.

For most programs, the program director should be a full-time position.


Official transcript (minimum of Baccalaureate Degree) Copy of National Registry or State License CV with formal education/degrees & related experience Signed/dated Letter of Appointment Signed/dated Letter of Acceptance



The Bachelor’s degree must be awarded by an academic institution that is accredited by an institutional accrediting agency that is recognized by the United States Department of Education (USDE). The Bachelor’s degree may be in any major. (02/05/2011)

Standard III.B.2.a. Medical Director Responsibilities The medical director must be responsible for medical oversight of the program, and must:

1) review and approve the educational content of the program curriculum for appropriateness, medical accuracy, and reflection of current evidence-informed prehospital or emergency care practice.

2) review and approve the required minimum numbers for each of the required patient contacts and procedures listed in these Standards.

3) review and approve the instruments and processes used to evaluate students in didactic, laboratory, clinical, and field internship,

4) review the progress of each student throughout the program, and assist in the determination of appropriate corrective measures, when necessary.

Corrective measures should occur in the cases of adverse outcomes, failing academic performance, and disciplinary action.

5) ensure the competence of each graduate of the program in the cognitive, psychomotor, and affective domains,

6) engage in cooperative involvement with the program director,

7) ensure the effectiveness and quality of any Medical Director responsibilities delegated to another qualified physician.

8) ensure educational interaction of physicians with students.

The Medical Director interaction should be in a variety of settings, such as lecture, laboratory, clinical, field internship. Interaction may be by synchronous electronic methods.


Written job description Teaching and administrative workload assignments Review of surveys (student, program, clinical, field, graduate, & employer) Reviews/Approves overall progress of each student Approval of curriculum Approval of terminal competency for each student Regular communication with PD (Checklist sign offs, email, etc.)


There must be written documentation that the Medical Director fulfills each of the responsibilities:

1) Documentation could include a signed memorandum stating the nature of review activities, dates conducted, etc.

2) Documentation could include a signed memorandum stating the nature of review activities, date of


review, etc. This responsibility does not mean that the Medical Director must be present for each type of activity – only that he/she reviews and approves. Review of evaluations is for those that relate to the students, not the faculty/staff. The Medical Director is not responsible for evaluation of program personnel.

There must be evidence of interaction between the Medical Director and the students.

3) Documentation could include descriptions of on-going activities, date(s) of communication with program director for such activities, etc.

4) Documentation must include a terminal competency form for each graduate signed and dated by the Medical Director); [A CoAEMSP Terminal Competency form is available on the CoAEMSP web site for use by the program, if so desired.]

At the conclusion of the program there must be a document signed by the Medical Director attesting to the competence of each graduate as an entry-level Paramedic. A terminal competency form for each student must contain a dated original signature by the medical director. A stamped signature is not acceptable. A secure electronic signature is acceptable.

A secure electronic signature is not a jpeg or other type of image attached to a document. A secure electronic signature is unique and under the sole control of the individual making the signature, the technology used must be able to identify the person making the signature, and the technology must be able to identify if the document was changed in any way after the electronic signature was applied. 6) The Medical Director maintains final responsibility for items 1 thru 5.

Standard III.B.2.b. Medical Director Qualifications The Medical Director must:

1) be a physician currently licensed and authorized to practice in the location of the program, with experience and current knowledge of emergency care of acutely ill and injured patients,

2) have adequate training or experience in the delivery of out-of-hospital emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care,

3) be an active member of the local medical community and participate in professional activities related to out-of-hospital care,

4) be knowledgeable about the education of the Emergency Medical Services Professions, including professional, legislative and regulatory issues regarding the education of the Emergency Medical Services Professions.


CV with formal education/degrees & related experience Signed/dated Letter of Appointment Signed/dated Letter of Acceptance Copy of State License for each licensed



The program must have a formal relationship with a physician currently authorized to practice in each state where the program’s students are participating in patient care, to accept responsibility for the practice of those students.

Standard III.B.3.a. Associate Medical Director Responsibilities When the program Medical Director delegates specified responsibilities, the program must designate one or more Associate Medical Directors. The Associate Medical Director must:

1) Fulfill responsibilities as delegated by the program Medical Director.

Possible Evidence of Compliance For This Standard (if applicable):

Written job description



Standard III.B.3.b. Associate Medical Director Qualifications The Associate Medical Director must:

1) be a physician currently licensed and authorized to practice in the location of the program, with experience and current knowledge of emergency care of acutely ill and injured patients,

For a distance education program, the location of program is the mailing address of the sponsor. 2) have adequate training or experience in the delivery of out-of-hospital emergency care, including the

proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care,








Standard III.B.4.a. Assistant Medical Director Responsibilities When the program Medical Director or Associate Medical Director cannot legally provide supervision for out-of-state location(s) of the educational activities of the program, the sponsor must appoint an Assistant Medical Director.

1) Medical supervision and oversight of students participating in field experience and/or field internship


Copy of State License for each licensed [Please Note: For comprehensive reviews, for each state in which the program has enrolled students, the program must provide evidence that it has successfully notified the State EMS Office that the program has students in the state.]



Standard III.B.4.b. Assistant Medical Director Qualifications When the program Medical Director or Associate Medical Director cannot legally provide supervision for out-of-state location(s) of the educational activities of the program, the sponsor must appoint an Assistant Medical Director. The Assistant Medical Director must:

1) be a physician currently licensed and authorized to practice in the jurisdiction of the location of the student(s), with experience and current knowledge of emergency care of acutely ill and injured patients,

2) have adequate training or experience in the delivery of out-of-hospital emergency care, including the proper care and transport of patients, medical direction, and quality improvement in out-of-hospital care,








Standard III.B.5.a. Faculty / Instructional Staff Responsibilities [Formerly III.B.3.a in the 2005 Standards]

In each location where students are assigned for didactic or clinical instruction or supervised practice, there must be instructional faculty designated to coordinate supervision and provide frequent assessments of the students’ progress in achieving acceptable program requirements.




“Instructional Faculty” includes paid or unpaid part-time or adjunct faculty, instructional staff, preceptors, or any other title associated with the individual responsible for the supervision and/or assessment of the student.

Standard III.B.5.b. Faculty / Instructional Staff Qualifications [Formerly III.B.3.b in the 2005 Standards]

The faculty must be knowledgeable in course content and effective in teaching their assigned subjects, and capable through academic preparation, training and experience to teach the courses or topics to which they are assigned.

For most programs, there should be a faculty member to assist in teaching and/or clinical coordination in addition to the program director. The faculty member should be certified by a nationally recognized certifying organization at an equal or higher level of professional training than the Emergency Medical Services Profession(s) for which training is being offered.


CV with formal education/degrees & related experience




Standard III.B.6.a. Lead Instructor Responsibilities When the Program Director delegates specified responsibilities to a lead instructor, that individual must:

Perform duties assigned under the direction and delegation of the program director.

The Lead Instructor duties may include teaching paramedic or AEMT course(s) and/or assisting in coordination of the didactic, lab, clinical and/or field internship instruction.





Standard III.B.6.b. Lead Instructor Qualifications The Lead Instructor must possess

1) a minimum of an associate degree 2) professional healthcare credential(s) 3) experience in emergency medicine / prehospital care, 4) knowledge of instructional methods, and 5) teaching experience to deliver content, skills instruction,

and remediation. Lead Instructors should have a bachelor’s degree.

The Lead Instructor role may also include providing leadership for course coordination and supervision of adjunct faculty/instructors.

The program director may serve as the lead instructor.


Official transcript (minimum of Associate Degree) CV with formal education/degrees & related experience Signed/dated Letter of Appointment Signed/dated Letter of Acceptance Copy of National Registry or State License


The Associate’s degree must be awarded by an academic institution that is accredited by an institutional

accrediting agency that is recognized by the United States Department of Education (USDE). The Associate’s degree

may be in any major. (01/01/2016)


Standard III.C.1. Curriculum The curriculum must ensure the achievement of program goals and learning domains. Instruction must be an appropriate sequence of classroom, laboratory, clinical/field experience, and field internship activities. Progression of learning must be didactic/laboratory integrated with or followed by clinical/field experience followed by the capstone field internship, which must occur after all core didactic, laboratory, and clinical experience. Instruction must be based on clearly written course syllabi that include course description, course objectives, methods of evaluation, topic outline, and competencies required for graduation. The program must demonstrate by comparison that the curriculum offered meets or exceeds the content and competency of the latest edition of the National EMS Education Standards.


List of all courses required for completion of the program [Appendix D – Program Course Requirements Table form available at http://coaemsp.org/Self_Study_Reports.htm].

Documentation demonstrating the comparison of program curriculum with the latest National EMS Education Standards

Written course descriptions for all required courses in the curriculum, course syllabi, learning outcomes, evaluation procedures to measure student competency


Progression of learning typically involves didactic/theory followed by laboratory practice followed by clinical experience followed by capstone field internship. The required curriculum content topics should be documented through course syllabi, lesson plans, supplemental instructional materials, textbooks, reference materials, etc, which lead to accomplishment of the program goals and outcomes. In order to assure entry-level competence, the program must adopt a skills assessment system that results in a portfolio which documents the evaluation of the progression of each student through individual skills acquisition, scenario labs, clinical and capstone field internship. The program shall evaluate and document student progression over time. This assessment system should represent best practices in education, measurement and documentation of the affective, cognitive, and psychomotor domains. Program completion is defined as successful completion of all phases (didactic, clinical, field experience, and capstone field internship).



Standard III.C.2. Curriculum (Tracking) The program must set and require minimum numbers of patient/skill contacts for each of the required patients and conditions listed in these Standards, and at least annually evaluate and document that the established program minimums are adequate to achieve entry-level competency. Further pre-requisites and/or co-requisites should be required to address competencies in basic health sciences (Anatomy and Physiology) and in basic academic skills (English and Mathematics).


Approval by Medical Director (e.g., signed letter, email correspondence) and endorsement by Advisory Committee (e.g., minutes)


Documentation of summary tracking demonstrating program required minimums


The program must establish the minimum number of encounters for each of the competencies for each of the defined distributions. (see Interpretation III.A.2)

Standard III.C.3. Curriculum (Team Leads) The field internship must provide the student with an opportunity to serve as team leader in a variety of pre-hospital advanced life support emergency medical situations. AEMT is based on competency, but may be typically 150-250 beyond EMT, which is 150-190, and may be taught separately or combined.



Documentation of tracking team leads for each student


The capstone field internship site must allow students to assess and manage patients in the pre-hospital environment where he/she will progress to the role of Team Leader. Minimum team leads must be established by the program and accomplished by each student. The number of team leads is established and analyzed by the program through the program evaluation system and must reflect the depth and breadth of the paramedic profession. The program must show that the timing and sequencing of the team leads occur as a capstone experience and in relation to the didactic and clinical phases of the program so as to provide an appropriate experience to demonstrate competence.




Evaluating the effectiveness of being a team lead is under standard IV.A.1 and IV.A.2. Team Leadership Objective: The student has successfully led the team if he or she has conducted a comprehensive assessment (not necessarily performed the entire interview or physical exam, but rather been in charge of the assessment), as well as formulated and implemented a treatment plan for the patient. This means that most (if not all) of the decisions have been made by the student, especially formulating a field impression, directing the treatment, determining patient acuity, disposition and packaging/moving the patient (if applicable). Minimal to no prompting was needed by the preceptor. No action was initiated/performed that endangered the physical or psychological safety of the patient, bystanders, other responders or crew. (Preceptors should not agree to a "successful" rating unless it is truly deserved. As a general rule, more unsuccessful attempts indicate willingness to try and are better than no attempt at all.) To be counted as a Team Lead the Paramedic student must accompany the transport team to a higher level of care and function as Team Leader with the exception of termination of resuscitation in the field.

Standard III.D. Resource Assessment The program must, at least annually, assess the appropriateness and effectiveness of the resources described in these Standards. The program must include results of resource assessment from at least students, faculty, medical director(s), and advisory committee using the CoAEMSP resource assessment tools. The results of resource assessment must be the basis for ongoing planning and appropriate change. An action plan must be developed when deficiencies are identified in the program resources. Implementation of the action plan must be documented and results measured by ongoing resource assessment.


Results of student and personnel resource surveys using the CoAEMSP Resource Assessment Matrix (RAM)

Advisory Committee Meeting Minutes


The resource assessment surveys must be administered at least annually and be reflected in an ongoing resource assessment matrix. The completed matrix must be presented to the Advisory Committee as part of the evaluation system. Recognized deficiencies must have an action plan and a method of review to ensure the deficiency is corrected.


Standard IV.A.1. Student Evaluation-Frequency and Purpose Evaluation of students must be conducted on a recurrent basis and with sufficient frequency to provide both the students and program faculty with valid and timely indications of the students’ progress toward and achievement of the competencies and learning domains stated in the curriculum. Achievement of the program competencies required for graduation must be assessed by criterion-referenced, summative, comprehensive final evaluations in all learning domains.


List of evidence in progress


There are many types of evaluations that are required by the CoAEMSP. Achievement of the competencies required for graduation must be assessed by program criterion-referenced, summative, comprehensive final evaluations. Summative program evaluation is a capstone event that occurs when the capstone field internship is nearing completion. Summative comprehensive evaluation must include cognitive, psychomotor, and affective domains. Didactic/Cognitive Evaluation (see also IV.A.2- Documentation) The didactic evaluation system must include both formative and summative types of evaluations (e.g. quizzes, exams). There should be a progression in the level of questions toward higher levels of critical thinking. The examinations must be reviewed for validity and medical accuracy. The Medical Director must review the medical content and accuracy of the examination system. These activities must be documented [see III.B.2.a.2)] Validity must be demonstrated on major exams, but methods may vary depending on the number of students. All exams should be reviewed by item analysis, which may include difficulty index (p+) and discrimination index (point bi-serial correlation). For programs using a commercial testing product, the program must demonstrate, through the program’s own item analysis, that the test items used are valid and reliable for the program. Simply quoting the national validity and reliability information provided by the vendor does not adequately establish that the test items are valid and reliable for the specific curriculum of the specific program. The results of the review (based on program established criteria) must be documented as well as any changes to exams that resulted from the review. Programs with large enrollments may be able to employ recognized mathematical formulas.

STANDARD IV. STUDENT AND GRADUATE EVALUATION/ASSESSMENT


Psychomotor Evaluation (see also IV.A.2-Documentation) The program needs to have a system that provides evidence that the student moves from novice to entry level competence for each skill as evaluated individually and through scenario-based activities or patient care activities. The frequency of evaluations is determined by each program; however certain evaluations are required. The program must designate the minimum number of times that each student must successfully perform each skill. The program must be able to justify its numbers, which may relate to the national standards, local community needs, input from the Advisory Committee and/or approval by the Medical Director. Affective Evaluation (see also IV.A.2-Documentation) As important as the cognitive and psychomotor domains, the program must teach, monitor, and evaluate (i.e. grade) the attitudes and behaviors of the students, including interpersonal interactions. There must be at least one comprehensive affective evaluation of each student, separate from affective components of clinical/field evaluations. The program must maintain records of the regular affective evaluations. On-going, documented affective evaluations must be done that assess student behaviors for all learning settings (i.e., didactic, laboratory, clinical, and field) with combined or separate instruments. The affective evaluation items may be incorporated with other evaluations (e.g., skill, competency, capstone field internship). The frequency of the evaluations need to be done in a timely manner to provide the student and at least the program director and medical director with his/her performance/ progress throughout the program. These periodic affective evaluations are in addition to the required summative, comprehensive affective evaluation at the end of the program. When the program determines that a student is not exhibiting appropriate behaviors, there must be evidence of counseling to attempt to correct the behavior, when appropriate, and continued evaluation of successful remediation or academic action (e.g. probation, failure). Terminal Competence The program must document that each students has reached terminal competence as an entry level paramedic in all three learning domains through a system of evaluation from novice to entry level competence and through scenario-based activities or patient encounters (e.g., portfolio). Determination of terminal competence is a joint responsibility of the program and the medical director. The Medical Director must certify and document terminal competence. [see III.B.2.a.4)].

Standard IV.A.2. Student Evaluation-Documentation a. Records of student evaluations must be maintained in sufficient detail to document learning progress and achievements, including all program required minimum competencies in all learning domains in the didactic, laboratory, clinical and field experience/internship phases of the program. b. The program must track and document that each student successfully meets each of the program established minimum patient/skill requirements for the appropriate exit point according to patient age-range, chief complaint, and interventions.


Terminal Competency Form (sample for use is located on the CoAEMSP website at http://coaemsp.org/Forms.htm)

http://coaemsp.org/Forms.htm



The program must have adequate methods to document those items described in Standard IV.A.1. Didactic/Cognitive Documentation The program must keep a master copy of all exams used in the program. Also, the program must maintain a record of student performance on every didactic evaluation. Psychomotor Documentation The program must keep a master copy of all psychomotor evaluation instruments used in the program. Also, the program must maintain a record of student performance on every psychomotor evaluation. The record could be a summary of scores or the individual graded skill sheets. Documentation should show progression of the students toward terminal competency. Affective Documentation The program must keep a master copy of all affective evaluation instruments used in the program. Also, the program must maintain a record of every student’s affective evaluation(s). Evaluations of all learning domains should be reviewed with students in a timely fashion. Evidence of review is required. A record of all counseling and the results must be maintained by the program. It is expected that the school will meet with each student at least once each academic session (e.g., semester, term, quarter) in sufficient time that the student can adequately respond to the counseling, as needed. Counseling includes, but is not limited to, exchange of information between program personnel and a student providing academically related advice or guidance for each of the three learning domains. The school needs a policy on when student counseling will occur, such as

Routinely during an academic session (e.g., semester, quarter, term)

including as part of due process for disciplinary proceeding

academic deficiencies and the path for improvement

other issues that interfere with the teaching/learning process

the academic status of the student and what must occur for academic success in the course and/or program

a status assessment of the student’s academic progress for each learning domain The documentation of counseling session should include at a minimum:

The date of the counseling session

The reason for the counseling session

The essential elements of the discussion of the counseling, including corrective action and the timeline for that action

The decision of the result of the counseling

The signature of the school official doing the counseling

The student’s response to the counseling

The signature of the student acknowledging receipt of the counseling completed form.


Capstone Field Internship Documentation The program must keep a master copy of all capstone field internship evaluation instruments used in the program. Also, the program must maintain a record of student performance on every capstone field internship evaluation. The record could be a summary of scores or the individual evaluation instruments. Documentation should show progression of the students to the role of team leader as required by the program. The program must document a mechanism for demonstrating consistency of evaluation and progression of the student during team leadership. Terminal Competence Documentation The program must have a document signed by the Medical Director and the Program Director showing that the student has achieved the established terminal competencies for all phases of the program.

[The following was moved from IIIC2]

There must be a tracking system: either paper or computer based.

The tracking system must incorporate and identify the minimum competencies (program minimum numbers) required for each exposure group, which encompasses patient age (pediatric age subgroups must include: newborn, infant, toddler, preschooler, school-ager, and adolescent), pathologies, complaint, gender, and intervention, for each student. Intervention tracking must include airway management with any method or device used by the program. The tracking system must clearly identify those students not meeting the program minimum numbers.

Standard IV.B.1. Outcomes Assessment The program must periodically assess its effectiveness in achieving its stated goals and learning domains. The results of this evaluation must be reflected in the review and timely revision of the program. Outcomes assessments must include, but are not limited to: national or state credentialing examination(s) performance, programmatic retention/attrition, graduate satisfaction, employer satisfaction, job (positive) placement, and programmatic summative measures (i.e. final comprehensive student evaluations in all learning domains). The program must meet the outcomes assessment thresholds established by the CoAEMSP. “Positive placement” means that the graduate is employed full or part-time in the profession or in a related field; or continuing his/her education; or serving in the military. A related field is one in which the individual is using cognitive, psychomotor, and affective competencies acquired in the educational program.

“National credentialing examinations” are those accredited by the Institute for Credentialing Excellence.


CAAHEP Annual Report



Programs seeking Initial Accreditation are not required to have outcomes data, but must have a plan as to how they will collect and analyze the data upon achieving Initial Accreditation.

Standard IV.B.2. Outcomes Reporting The program must periodically submit to the CoAEMSP the program goal(s), learning domains, evaluation systems (including type, cut score, and appropriateness/validity), outcomes, its analysis of the outcomes, and an appropriate action plan based on the analysis.

Programs not meeting the established thresholds must begin a dialogue with the CoAEMSP to develop an appropriate plan of action to respond to the identified shortcomings.


CAAHEP Annual Report


The data reported in the annual report by programs achieving Initial Accreditation begins from the date that CAAHEP awards the Initial Accreditation. Continuing Accreditation programs are notified by the CoAEMSP each year as to the due date of the Annual Report submission. The most recently filed Annual Report is added to the Continuing-Accreditation Self Study Report (CSSR), when a continuing program undergoes comprehensive review. Starting in 2015, all accredited programs must publish, preferably in a readily accessible place on their websites, the 3-year review-window average results of the outcomes for:

NREMT or State (as applicable) Written and Practical pass rates, and

retention, and

positive placement At all times, the published results must be consistent with and verifiable by the online Annual Report of the program. Starting with the 2015 annual report, each year in the Comments tab of the on-line Annual Report, the program must state the website link (or other publication) where its results are published. If the program uses a means other than its website, it must describe those means in the Comments tab, and submit/upload as Related Documents, the materials by which it publishes the outcome results. Failure to meet the defined outcomes threshold over the most recent 3-year average may be considered by the CoAEMSP to be a Standards violation.


Standard V.A.1. Publications and Disclosures

Announcements, catalogs, publications, and advertising must accurately reflect the program offered.


Catalogue Website (current snapshot)




At least the following must be made known to all applicants and students: the sponsor’s institutional and programmatic accreditation status as well as the name, mailing address, web site address, and phone number of the accrediting agencies; admissions policies and practices, including technical standards (when used); policies on advanced placement, transfer of credits, and credits for experiential learning; number of credits required for completion of the program; tuition/fees and other costs required to complete the program; policies and processes for withdrawal and for refunds of tuition/fees.


Catalogue Institutional Policies and Procedures Program Policies and Procedures Student Handbook Faculty Handbook


The statement of program accreditation must be in accordance with CoAEMSP policy IV.A.3. The statement of a program holding a Letter of Review (LoR) must be made in accordance with CoAEMSP policy I.B.3. All students who are accepted for advanced placement (AP) must be accounted for in the annual report. Programs must demonstrate how advanced placement graduates meet all program minimum competency requirements in didactic, lab, clinical, and capstone field internships. All programs must have and publish their policy on advanced placement even if they do not utilize advanced placement.

STANDARD V. FAIR PRACTICES



At least the following must be made known to all students: academic calendar, student grievance procedure, criteria for successful completion of each segment of the curriculum and for graduation, and policies and processes by which students may perform clinical work while enrolled in the program.


Catalogue Institutional Policies and Procedures Program Policies and Procedures Student Handbook Faculty Handbook Website (current snapshot)




The sponsor must maintain, and make available to the public, current and consistent summary information about student/graduate achievement that includes the results of one or more of the outcomes assessments required in these Standards.

The sponsor should develop a suitable means of communicating to the communities of interest the achievement of students/graduates (e.g., through a website or electronic or printed documents).






Standard V.B. Lawful and Non-Discriminatory Practices

All activities associated with the program, including student and faculty recruitment, student admission, and faculty employment practices, must be non-discriminatory and in accord with federal and state statutes, rules, and regulations. There must be a faculty grievance procedure made known to all paid faculty.

A program conducting educational activities in other State(s) must provide documentation to CoAEMSP that the program has successfully informed the state Office of EMS that the program has enrolled students in that state.





Standard V.C. Safeguards

All activities required in the program must be educational and students must not be substituted for staff.




For educational activities, individuals must be clearly identified as students, in a specified clinical/field experience/internship, under the auspices of the program medical director, and under the supervision the designated preceptor prior to performing patient care. Students must not be substituted for staff.

Standard V.D. Student Records Satisfactory records must be maintained for student admission, advisement, counseling, and evaluation. Grades and credits for courses must be recorded on the student transcript and permanently maintained by the sponsor in a safe and accessible location.






Standard V.E. Substantive Change The sponsor must report substantive change(s) as described in Appendix A to CAAHEP/CoAEMSP in a timely manner. Additional substantive changes to be reported to CoAEMSP within the time limits prescribed include:

1. Change in sponsorship 2. Change in location 3. Addition of a satellite location 4. Addition of a distance learning program





Standard V.F. Agreements There must be a formal affiliation agreement or memorandum of understanding between the sponsor and all other entities that participate in the education of the students describing the relationship, roles, and responsibilities of the sponsor and that entity.




There must be current affiliation agreements with clinical affiliates and capstone field internship sites that define the responsibilities of both the program and the sponsor, detailing what the students can do at the site, and the responsibilities of the preceptor. NOTE: If the sponsor is a consortium, the agreements must be with the consortium, in the name of the consortium, and signed by the Chair of the consortium governing body, on behalf of the consortium sponsor. Contracts may have automatic renewal provisions, but the program should show evidence of periodic review that the affiliation continues to meet the needs of the program.


If the program uses a secure electronic signature, documentation of the agreement must exist between the parties allowing for such signature. A secure electronic signature is not a jpeg or other type of image attached to a document. A secure electronic signature is unique and under the sole control of the individual making the signature, the technology used must be able to identify the person making the signature, and the technology must be able to identify if the document was changed in any way after the electronic signature was applied.

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